Objective: The optimal timing of coronary revascularization after acute myocardial infarction (MI) remains a matter of debate. We examined the influence of time elapsed between acute MI and isolated CABG surgery on hospital mortality and morbidities.
Methods: We examined the results of isolated CABG after acute MI in 60 patients between July 2009 and January 2011, two groups were evaluated: group A, 30 patients with early (0-2 days) CABG after MI; group B, 30 patients with late (>2 days) CABG after MI. Demographics, intraoperative, and postoperative variables were collected and compared among both groups.
Results: Groups were well-matched demographically. Intraoperative, the use of LIMA was less in the early surgery and the use of SVG as the only grafts was more in the early surgery group. Analysis of postoperative variables revealed, increased need for IABP (P value=0.011), and more incidence of low cardiac output syndrome after early CABG (P value = 0.01). Other complications and postoperative mean ventilation time, mean ICU stay, and the mean hospital stay were more in the early group but without statistical significant difference. The hospital mortality was more in group A (6.6%) than in group B (3.3%), with no significant statistical difference. The use of IABP and LCOS were identified as independent risk factors for mortality by logistic regression analysis. (P value = 0.039 and 0.049 respectively).
Conclusion: We detected significant increase in postoperative complications in the patients undergoing coronary artery bypass grafting within 2 days after acute MI, indicating higher risk after early surgical revascularization, and surgery may best be delayed for 3 or more days after acute myocardial infarction.
Keywords: CABG, myocardial infarction, timing